Bleach white or die trying

NAKED, the skinny toddler lay swaddled in a blanket of sweat on the hospital bed. Splayed across the sheet like bruised violet, she cut the picture of a child in extreme agony. Time was 3.45 p.m. and the torrent outside had subsided to a drizzle but the tiny tot continued to drip with sweat. Few minutes later, her cherubic face yielded to a grimace, her pinkish lips twisted into a pout and her tiny fingers flailed across her belly to scratch at her back.

Closer, she wasn’t such a pretty sight. Her clammy skin was a curtain of rash and scratch sores; every time she breathed, she whimpered like a newborn suffocating in a woolly shawl. Her name is Eva (surname withheld) and she is three years old.

Contrary to the hospital doctor and matron’s initial diagnosis, Eva had developed no fever neither was she reacting to a clinical drug; the creepy rash on her skin, her mottled complexion and burdensome perspiration were direct consequences of her mother’s love for her.

Call it twisted love if you like but Ndidi, a tailor and the toddler’s mother, professes uninhibited care for her daughter, and in a rare display of maternal affection for her child, Ndidi mixed Eva’s baby lotion with her personal skin whitener.

Ndidi said: “Na so I dey mix am and use am for am since she reach five months. Nothing do am since I don dey use am for am…Na the cream save her colour because she dey get heat rash well well. Na hin make the heat rash go. I no fit kill my own child now…roughly translated thus: “That’s how I have been mixing it and using it for her since she clocked five months. She can’t come to any harm thereby…I do it to preserve her complexion and take care of her skin. It is what I used to cure her of her heat rash. I can’t harm my own child.”

Ronke Egbeyemi, the Chief Matron of the Ijoko, Ogun State-based clinic where little Eva is recuperating, revealed that the three-year-old had been subjected to a heavy cocktail of skin bleachers by her mother. Further findings revealed that Ndidi has been spending an average of N4, 500 per month on skin bleachers on her daughter’s skin although the money could adequately pay for a pack of learning materials or multivitamins and baby milk for the malnourished child.

“I do not know what is wrong with the mother but if the girl’s nanny hadn’t rushed her to our clinic, who knows what state the poor child would be in now?” said Egbeyemi. According to her, Eva’s nanny reported that the child had suddenly broken into a loud wail just before her lunch hour. “The nanny claimed that she tried unsuccessfully to pacify her,” stated Egbeyemi.

Corroborating her, the nanny, who simply identified herself as Hadiza, noted that she had always wondered why little Angel was persistently covered in sweat. “That afternoon, she started screaming suddenly and tugging at her dress. When I pulled it off her, I discovered that she was sweating profusely and her body was covered in red sores.”

Ndidi, however, refused to accept that it was the skin whitener she had been applying on her child that was responsible for her medical condition. According to her, “The cream no do am anything. Na im true colour the cream dey bring out. Before, dem talk say na malaria do am, today dem dey say na me poison am with bleaching cream. Make dem kuku talk say dem no know wetin do am,” roughly translated thus: “The cream didn’t harm her. It simply brings out her true colour. Earlier they diagnosed her of malaria; today, they claim I poisoned her with bleaching cream. They should simply own up that they don’t know what is wrong with her.”

Maddened by her lack of contrition, Festus, her estranged husband and police constable, has decided to take his child away from her. “That (Eva) is my only daughter. I will not wait for her (Ndidi) to kill her for me,” he said, adding that he would be taking Eva away to live with him and his “legal wife.”

Several kilometres from the Ijoko, Ogun State scene of the skin bleaching accident, in Mosalasi, Lagos to be precise, Felicia, a self-styled beautician and pub owner, operates a burgeoning business. While she plays the role of a general overseer, she lets her three daughters learn the ropes of the business by taking charge of it.

Every day, the mother and grandma engage in a lucrative routine mixing skin bleachers for neighbourhood housewives, undergraduates and teenagers for as little as N1, 500 and as much as N3, 000. With their faces tone-bleached and heavily made up like the shiny moss crust coating the base of her brightly coloured beauty kiosk and makeshift pub beside it, you’d think they were primed to espouse a poetry of contrariety. Shades of red, green and black cast unattractive traceries along Felicia’s veins. Add that to her scaly and badly wrinkled skin and you have a perfect portrait for an anti-bleaching campaign. But Felicia argued that the rapid deterioration of her skin was caused by a minor bruise and “bad weather.” “I no dey bleach o. You call dis one bleaching? Na toning I dey tone,” she said, adding that her business is lucrative because she offers quality service at very cheap prices.

‘It’s not bleaching, it is light toning’

Not a few women, irrespective of education, exposure and social class share a similar mentality with Felicia. “There is a difference between light toning and skin bleaching. Even those creams have it indicated on their leaflets if they are meant to bleach or slightly tone the user’s skin to attain its real glow. The cream I use for instance is meant for light toning and clearing of acme and dark spots. It doesn’t bleach,” claimed Bunmi Adedotun, an advertising executive.

Corroborating her, Kikelomo Ayinde-Roberts, a clothier and beauty products importer, stated that “Bleaching is different from toning. And there is nothing wrong with bleaching if you can find the right cream for your skin type. The key is to find the proper cream or mixture that would interact well with your skin. You see, my skin type interacts well with a mixture I discovered three years ago; when my friend tried it, it burnt her skin. I had to recommend another cocktail for her. I also make recommendations for many of these society women you see around,” claimed the clothier even as she scratched a mottled spot on her chin.

Skin lightening and global capital

Besides established skin bleaching product line manufacturers, contemporary beauty circuits currently bloom with the emergence and preponderance of self-styled skin care and bleaching specialists. Many women and girls now concoct their own treatments or purchase products from self-styled beauty experts offering special creams, soaps, or lotions.

The Nation findings revealed that the glutathione injection is valued between N200, 000 and N300, 000 for high end users. “However, to guarantee the effectiveness of the treatment, you have to buy and use glutathione capsules regularly. The capsules cost between N50, 000 and N70, 000,” disclosed Iyabo Senoma, a grocer who is currently undergoing the glutathione treatment at an exclusive spa in Ajah, Lagos.

Further findings revealed that new fascination with skin bleachers and the status-enhancing whitening treatment has caught on in the upscale social circuits of Lagos. Predictably, dealers of skin lightening products have emerged with beauty parlors springing up within and about exclusive and commercial nerve centres of the city.

Many of these spas and skin bleaching parlours often promise a lighter, radiant and spot-free complexion for clients at specified rates. Estimates by Global Industry Analysts indicate that the market for skin bleachers will exceed N150 billion globally by 2015.

But while the affluent throng the trendy bowels of contemporary high end beauty parlours, less affluent patrons frequent the modest bleaching parlours. At Mama Tega Cosmetics (MTC) beauty parlour in Yaba market, the price varies for skin whitening cocktails. “And if you have a “Skin Mission” as per, whitening, and you don’t have up to the statutory N25, 000, she will recommend another product that fits your budget,” croons an MTC enthusiast. At BISMID Cosmetics, a jar of different skin whitener is available at N3, 000. Several other beauticians offer varieties of skin whiteners and mixtures at various prices depending on their clients’ purse.

At low-budget, makeshift beauty parlours like Felicia’s for instance, skin whitening creams cost between N150 a tube to N5, 000 a jar.

Rosemary Oruan, a dermatologist and ‘registered and internationally trained beautician,’ however, stated that many of the products are often ineffective sham products or else effective but containing highly toxic materials such as mercury, hydroquinone and lead.

Bleaching at a glance

Bleaching is a process by which different products are used for the purpose of lightening normally dark skin. These agents remove the melanin pigment but do not destroy the melanin producing cells. Thus, daily use combined with minimization of exposure to the sun is required for persistence of the lightening effect. The race to be white has however attained an alarming proportion in Nigeria.

Skin bleaching or lightening is a global phenomenon; however, in recent years, the practice has come under fire because of its potential negative health effects and association with colonialism and self-imagery. There is evidence that some types of skin-whitening products use harmful active ingredients such as mercury and hydroquinone. Hydroquinone is banned in many other countries and can only be prescribed by a doctor.

Why bleach?

Several social pressures favouring lighter skin tone among Africans have been previously identified. Grace Nwogu, a dermatologist, blamed “mischievous media advertisements which usually glorify lighter skin tone at no cost” for the prevalence of use of bleaching cosmetics by Nigerian females. According to her, “these products are sold solely in local shops patronised by Africans, rather than traditional pharmacies or cosmetic shops. Most are sold as cosmetic products in non-medical stores without warning about adverse effects or contraindications. With persistent usage, most users of these products end up with badly damaged skins.”

On another note, Mariam Alebiosu, a consultant clinical psychologist, identified the rating of skin colour as a determinant of social class as one of the many factors pushing uninformed Nigerians to try out skin bleaching. “At the end, in their search for prestige, they end up with badly damaged skin,” noted Alebiosu.

There have been local and transnational campaigns to stop the manufacture of products containing mercury in the EU and efforts to inform African consumers of the dangers of their use and to foster the idea of black pride. Governments in South Africa, Zimbabwe, Nigeria and Kenya have banned the import and sale of mercury and hydroquinone products but they continue to be smuggled in from other African nations.

Despite these efforts, the use of skin lighteners has been increasing among modernised and cosmopolitan Nigerian women as well as their African peers. The prevalent situation undoubtedly contradicts the situation back in the 1970s when typical skin lightener users were constituted mostly by prostitutes, desperate spinsters, divorcees and the rural poor. The media often portrayed women who bleach as naïve, irrational and gullible. But nowadays, ladies are no longer ashamed to bleach or even talk about it with pride in some social circles.

More worrisomely, local entertainers to whom several youngsters look up to as role models engage in a scramble for skin bleachers. Many who had black skin now flaunt extremely whitened complexion in the wake of heavy application of skin whiteners to their skin.

In early January 2014, Reprudencia Sonkey a.k.a Dencia, a Cameroonian artiste with notable presence in Nigeria, launched Whitenicious, a skin care line. Within 24 hours, the product sold out and “before” and “after” pictures (that is, testimonial pictures) of the artiste generated buzz on the internet. Three weeks later, demands for the product escalated to 20,000 units and showed no signs of slowing down. Although the product promotes itself as a “7-day fast acting dark spot remover,” Dencia received knocks for not only promoting skin lightening, but self-hatred among women of colour and more specifically, African women.

In the heat of the backlash, Dencia stands behind Whitenicious, arguing that she is in fact helping women overcome an obstacle. In an interview with United States-based Ebony Magazine, Dencia defended her product line, stating: “This product doesn’t have hydroquinone, it doesn’t have steroids, and it doesn’t have mercury.” Dencia claims the skincare cream is intended to remove dark spots, and that it is out of her control if customers use it to whiten their entire skin. Defending her own drastically altered appearance since she started using Whitenicious, the singer asserts: “I was never that dark in real life… And guess what? I don’t even care because [critics] are bringing me business.”

According to the World Health Organisation, 77 per cent of Nigerian women use skin lightening products on a regular basis. It is also reported that some women use these products for as long as 20 years. The number is growing by the day. It is generally believed that this practice is influenced by deep racial inferiority, ignorance of identity or a crisis of identity but it is important to note that there is more to it than this.

For some of the women, skin lightening satisfies their need for attention, their desire for beauty as seen in magazines where models and celebrities have light coloured skin. It can be seen as perpetuating the colonial belief that being lighter is better.

Today, it is the upwardly mobile Nigerian women, those with technical diplomas or university degrees and well-paid jobs, who are driving the market in skin lighteners. A recent study by Mictert Marketing Research found that one in 13 upwardly mobile black women aged 25 to 35 use skin lighteners frequently.

Dangers of skin-bleaching

A recent study carried out to assess immunologic skin tests and hematological indices in the users of skin lightening creams in Nigeria produced worrisome findings. The test, which has been published in international medical research journals, was carried out by a team of researchers led by Ganiyu Arinola (PhD) of the Department of Chemical Pathology and Immunology, College of Medicine, University of Ibadan (UI), Nigeria,Ibadan, Oyo State.

The laboratory test featured 60 participants; 30 of them were skin bleachers who had used lightening creams for average of 4.9 years, while the remaining 30 who had never bleached their skins, served as the control group. The subjects were recruited from various locations within the city of Ibadan. All the participants gave willing consent after the nature and objectives of the study were explained to them. Those with history of asthma, tuberculosis infection or BCG vaccine (confirmed by the mark on the upper arm) as well as those on medication (e.g. immunosuppressive or antibiotic drugs) were excluded from the study. The study had the approval of the University of Ibadan/University College Hospital Joint Ethical Review Committee, Ibadan, Oyo State.

Results: The mean values of PCV and neutrophils (white blood cells) were significantly lower, while the mean value of lymphocytes was higher in the users of skin lightening creams when compared with the control group. There was significantly increased diameter of skin reaction to Mantoux test in the users of skin lightening creams when compared with the controls. Skin prick test also showed significantly increased reaction diameter with dog epithelia antigen in the users of skin lightening creams when compared with controls.

Significantly higher proportions of the users of skin lightening creams were positive to GS2 cockroach antigen, standardised mite antigen and mouse epithelia antigen when compared with the controls. The epidermis layer of the skin plays important role in the body immunological defense against pathogens (disease causing bacteria and other parasites).

“Whenever the skin immune defence mechanism is impaired, the skin is expected to become prone to various infections. The presence of infectious agents will mobilise the polymorphonuclear cells (PMN) to the site of infection, thereby causing reduced circulating neutrophils, that is white blood cells. (White blood cells are needed to protect the body from germs or deadly infections.)

“In this study, the mean level of circulating neutrophils (white blood cells) was found to be significantly lower, while the mean level of circulating lymphocytes was found to be significantly higher in test subjects compared with the controls. Thus, suggesting possibility of localised infection of the skin.

“The mean level of packed cell volume in test subjects was significantly lower in the test when compared with the controls. This might be due to red blood cells destruction by skin lightening creams that entered blood circulation through permeabilised skin.

Positive Mantoux skin test reaction suggests the presence of activated phagocytes (Phagocytes are cells that protect the body by ingesting (phagocytosing) harmful foreign particles, bacteria, and dead or dying cells) due to infection by Mycobacterium tuberculosis or environmental Mycobacteria.

Conclusion: According to Dr. Arinola and his team, “The study shows that skin lightening creams cause disruption in the normal immunologic functions (Types I and IV hypersensitivity states) of the skin and certain hematological parameters. There is need for public awareness programme to enlighten the populace about the danger involved in the practice of skin lightening. Skin lightening disrupts primary innate immune function of the epidermal skin leading to susceptibility of the users to localized or systemic infections since lightening creams used for long duration, on a large body surface area and under hot humid conditions enhanced percutaneous absorption.

“In addition, higher susceptibility to infections in these people may lead to an increased of phagocytes in response to infections which generated free radicals, increased utilisation of antioxidants, thus lowering the antioxidant potential which may lead to a state of oxidative stress and increased in the rates of skin cancer. Other side effects of skin lightening creams are damage of elastic fibers of the skin, skin wrinkling, ochronosis, acrodynia, contact allergy, stretch marks and ache. This study is designed to investigate the possible effects of skin lightening cream on skin immune status by determining the skin responses to environmental antigens. (An antigen is any substance such as chemicals, bacteria, viruses, or pollen that causes your immune system to produce antibodies against it,” stated the research team.

More gruesome news…

Prolonged use of bleaching agents, with the loss of the protective effect of melanin pigment, combined with sun exposure can theoretically lead to an increased risk of skin cancer, according Fortune Okerereke, a dermatologist. According to her, incessant use of skin whiteners also causes premature aging as the harsh chemicals in the creams cause serious damage to the elastic fibers of the skin. Hydroquinone causes a paradoxical increased pigmentation of the skin, called ochronosis. This results from pigment deposition in the deeper parts of the skin. Other complications include eczema, as these agents are often irritating to the skin. With steroid use, the main side effect is the increased risk of skin infections, for example, fungal infections and scabies. There is also skin thinning, with the development of stretch marks and acne. Furthermore, with the uncontrolled use of steroids on the skin, individuals may experience poor wound healing.

With the use of more potent steroid creams, applied over a large body surface area, there is a risk of systemic side effects, including the development of high blood pressure and diabetes. Mercury agents12 when applied to the skin in sufficient quantities can be absorbed leading to mercury poisoning, which is manifested by a range of symptoms, including psychiatric, neurological and kidney problems. Mercury of course is highly toxic, and sustained exposure can lead to neurological damage and kidney disease. Hydroquinone (originally an industrial chemical) is effective in suppressing melanin production, but exposure to the sunhard to avoid in Africadamages skin that has been treated.

Systemic side effects of some of these agents (including mercury poisoning) may also be observed in babies if they are used by pregnant or breast feeding women. According to local dermatologists, skin lightening disrupts primary innate immune function of the epidermal skin leading to susceptibility of the users to systemic infections since lightening creams used for long duration, on a large body surface area and under hot humid conditions enhances absorption. In addition, higher susceptibility to infections by users may lead to a state of oxidative stress and increase in the rates of skin cancer. Other side effects of skin lightening creams are damage of elastic fibers of the skin, skin wrinkling, contact allergy, stretch marks and ache.

Skin bleaching as a mental problem

Dr. Daudi Ajani ya Azibo, an independent scholar and expert in African-centered (Black) Psychology, postulated through his “Azibo Nosology,” the only diagnostic system of mental disorders directly linked to African-centered personality theory. The body of work is currently the fifth most cited article in the history of the Journal of Black Psychology (JPB).

According to Azibo, within every culture, one might find as an exception an individual who is radically out of step with his or her culture regarding a given behaviour. The notion that there may be individual bleachers or lighteners who engage in the behaviour for reasons far removed from the abnormal is basically according to him. Such behaviour is often more inappropriate and pathological than “normal,” he claimed.

The behaviour of so-called “odd duck” persons or persons marching to their own drum, so to speak, is evaluated as not mentally ill so long as it is not anti-self/anti-African in motivation or actuality and is neither harmful to maintaining African civilisation nor the African individual himself or herself. However, the moment it begins to constitute harm to the skin bleacher, it becomes a criterion for abnormalcy in every abnormal psychology textbook. These principles would appear reasonable. Fathoming the psychology of individuals who bleach or lighten without violating these principles does not seem possible, especially in the light of their reactive status as occurs under Eurasian domination of Africans, he argued.

Taming a monstrous trend

One often-proposed solution to the problem is re-orientation that stresses the diversity of types of beauty and desirability and that valorises darker skin shades, so that lightness or whiteness is dislodged as the dominant standard. But while such efforts are needed, it is noteworthy that focusing only on individual consciousness and motives distracts attention from the very powerful economic forces that help to create the yearning for lightness and that offer to fulfill the yearning at a steep price.

Seyi Akinwumi, a Lagos-based lawyer, recommended that the Standards Organisation of Nigeria (SON) and National Agency for Food, Drugs, Administration and Control (NAFDAC), and other government regulating agencies in control of the regulations and importation of cosmetics and pharmaceutical products should ensure that such undesirable products are not registered or allowed entry into the country. She also suggested a follow-up action to educate young girls on the implications of using skin whiteners, toners, soaps and other toxic products.

Urgent steps need to be taken to outlaw the economic forces responsible for the influx of dangerous skin whiteners in the country, argued Adebola Adele, an international businessman and economist. According to him, the manufacturing, advertising, and sale of skin lightening cream has become a major growth market for giant multinational corporations with sophisticated means of creating and manipulating needs. The multinationals produce separate product lines that appeal to different target audiences. For some lines of products, the corporations harness the prestige of science by showing cross-sectional diagrams of skin cells and by displaying images of doctors in white coats.

Dark skin or dark spots become a disease for which skin lighteners offer a cure. For other lines designed to appeal to those who respond to appeals to naturalness, corporations call up nature by emphasising the use of plant extracts and by displaying images of light-skinned women against a background of blue skies and fields of flowers. Dark skin becomes a veil that hides individuals’ natural luminescence, which natural skin lighteners will uncover.

For all products, however, dark skin is associated with pain, rejection and limited options; achieving light skin is thus seen as necessary to being youthful, attractive, modern, and affluent, in short, to being “all that you can be.”